Name that drug

 73% of Wasco County child abuse cases are

______ related.
 99% of first-time ______ users are hooked after the
first try.
 ______ use among Oregon females under 17 and
under increased by 57% over the past 5 years.
 The life expectancy of a habitual ______ user is as
little as 5 years.
 Five pounds of toxic waste material is produced in
the manufacture of every one pound of ______
 ______ is tied to almost every property and identity
theft crimes in Oregon.
meth is very hot right now
 8;43pm<dusty_valentine>
Guess who was expelled from school and will be living w/ me in the fall (much to
my chagrin)?
 8:54pm<iam13yrsold>
your boy brother?!
 8:54pm<dusty_valentine>
the same.
as a result, I'm thinking of renaming my house 'thunderdome'.
 8:55pm<iam13yrsold>
You be his manager and set up a cage fighting arena in the basement
at least make some money
 8:55pm<dusty_valentine>
I wish. stoners don't make very good cage fighters.
I should get him on meth first
 8:56pm<iam13yrsold>
yes! Meth is Very hot right now.
 YouTube - Cocaine,Marijuana,Crack, Meth
,Heroin Changes ...

Face of addiction - The effects of crystal meth. 00:44 From ...

5 min -
www.youtube.com/watch?v=hzP-4N2Qfs0

www.youtube.com/watch?v=hzP-4N2Qfs0
Background: Street Names

 Methamphetamine
 Speed
 Meth
 Chalk

 Methamphetamine Hydrochloride (Crystalline)

 Crystal Meth
 Glass
 Ice
 drug class Stimulant
»Speed up signals to the brain”

Cocaine
Amphetamines –
Methampetamines
Methcathinone
Methylphenidate
Anorectic Drugs
Khat

Amphetamines, Caffeine, Nicotine Cocaine

Excite, arouse, increase alertness, elevate mood.

( Drugs in American Society, 7th edition, Erich Goode, McGraw-Hill, 2008. Chapter 1)
Methamphetamine
amphetamine was a drug in search of a disease”

Methamphetamine, in all its forms (po, snort, IV, smoked), is highly

addictive and toxic.

Effects of meth
similar to cocaine except onset is slower & duration is longer – remains in
CNS

Metabolism
Cocaine almost completely metabolized-
Meth -large % of drug remains unchanged in the body
 Mechanism of action

chemical formula C10H15N

molecular mass 149.233 g/mol.

triggers a cascading release of norepinephrine,

dopamine and serotonin.

to a lesser extent methamphetamine acts as a

dopaminergic and adrenergic reuptake inhibitor and
in high concentrations as a monamine oxidase
inhibitor

stimulates the mesolimbic reward pathway, causing

euphoria and excitement, it is prone to abuse and
addiction.
HIV JournalView:
Top 10 HIV Clinical Developments of 2007
David Alain Wohl, M.D.
University of North Carolina, AIDS Research and Treatment Unit
Newsworthy New Drugs

Presenting for Care Too Late and With Too Few CD4+ Cells

Myocardial Infarctions: The Role of PIs and NNRTIs

Metabolic Results From the A5142 Study -- Assumptions Gone Wild

Sperm Washing Works

Screening for Abacavir Hypersensitivity

The Sad Failure of a Promising HIV Vaccine

Crystal Meth Is Evil

Survival With HIV: Great Expectations

Risk of Cancer Is Related to Immune Function

www.thebodypro.com/content/art45308.html
Short term effects

Increased attention
Decreased fatigue
Increased activity
Decreased appetite
Euphoria and rush
Increased respiration
Hyperthermia
http://www.stopmethaddiction.com/effects-of-meth.htm
 long-term effects of meth use

Dependence
Addiction psychosis
Paranoia
Hallucinations
Mood disturbances
Repetitive motor activity
Stroke
Weight loss
Withdrawal
Users may become obsessed or perform repetitive
tasks such as cleaning, hand-washing, or
assembling and disassembling objects.

Withdrawal is characterized by excessive sleeping,

eating and depression-like symptoms, often
accompanied by anxiety and drug-craving.

Users often take one or more benzodiazepines as

a means of "coming down".
Clinical Presentation: meth
 variety of cardiovascular problems.
 rapid HR, irregular heartbeat, increased b/p, and irreversible, stroke-producing
damage to small blood vessels in the brain.
 Hyperthermia and convulsions occur with methamphetamine overdoses, and if
not treated immediately, can result in death.

 Chronic abuse
 inflammation of the heart lining, and among
 users who inject the drug, damaged blood vessels and skin abscesses.
 episodes of violent behavior, paranoia, anxiety, confusion, and insomnia.
 Heavy users also show progressive social and occupational deterioration.
 Psychotic symptoms can sometimes persist for months or years after use has
ceased.

 Acute lead poisoning

 production uses lead acetate as a reagent.
 Production errors may therefore result in methamphetamine contaminated with
lead.

 Fetal exposure
 prenatal complications, increased rates of premature delivery
 altered neonatal behavioral patterns, such as abnormal reflexes and extreme
irritability
 may be linked also to congenital deformities
Big Picture clinical presentation

Global
Regional
Community
Interpersonal
Individual
"Treatment response is poorer among methamphetamine abusers than
among cocaine abusers-fewer meth abusers could remain drug free,

…..methamphetamine abusers are twice as likely as cocaine abusers to

require some kind of medical treatment..

….methamphetamine abusers are more debilitated and show paranoia

and hallucinations. There is more violence associated with meth”……

http://www.drugabuse.gov/NIDA_notes/NNvol11N5/Escalating.html
Management:
Chemical Dependency Treatment

 Chemical Dependency Program (e.g. Matrix Model)

 Contingency management program with rewards for
patients with negative urine drug screens
 Medications which may offer benefit
 Fluoxetine and Bupropion may reduce short-term
cravings
 Imipramine improves compliance with therapy
 References
 Cretzmeyer (2003) J Subst Abuse Treat 24:267